Carinal reconstruction

Thirty-six carinal resections were performed: 23 for primary neoplasms of the airways, 5 for bronchogenic neoplasms, and 8 for inflammatory lesions. In 31 cases, primary reconstruction was done. Eleven reconstructions were performed without pulmonary resection; in 5, right upper lobectomy was also done, in 9 pneumonectomy, and 6 patients had had a prior left pneumonectomy. Five staged reconstructions were attempted. The mode of reconstruction depended on the precise location and extent of the lesion. Bronchial anastomoses to the side and end of the trachea or to the end of the trachea and to the side of a bronchus predominated. Four deaths occurred among the 31 patients who had primary reconstruction (13%). Two patients with anastomotic stenoses had successful reexcision. Attempts at staged reconstruction failed.